BACKGROUND:Myofascial trigger points have been widely applied in clinical rehabilitation and tissue pain field in the United States and Europe countries, and they have been recognized as the common cause of clinical musculoskeletal pain, joint function limitation, tissue injuries and muscle fatigue by many physiotherapists abroad. However, in China, many experts stil have some mistaken ideas and limitations to understand the pathological mechanism and to diagnosis and treat myofascial trigger points. OBJECTIVE:From the aspects of the etiology, pathological mechanism, diagnosis and positioning, treatments, to elaborate the method issues and the clinical experience of treatments of myofascial trigger points. METHODS:PubMed, ScienceDirect, EBSCO and CNKI databases were searched by the keywords of “myofascial trigger points, myofascial pain syndrome” in Chinese and English, respectively, in the titles and abstract to retrieve relevant articles published from the time of database construction to August 2014. RESULTS AND CONCLUSION:It is concluded that a child has myofascial trigger points in some skeletal muscles after age of 4 years. The main causes of myofascial trigger points include issue trauma, the wrong posture, bone and joint degeneration, nutrition deficiency, mental stress, chronic infection and so on. The pathological mechanism of myofascial trigger points remains unknown, but what has been widely accepted is the integrated trigger point hypothesis introduced by Simons. And how to find and position myofascial trigger points is the key point to treat this disease successfuly. The application of myofascial trigger points techniques is important for the rehabilitation of clinical tissue pain and the occurrence and spread of bone and joint injuries, myofascitis, muscle pain, muscle fatigue and so on.

Objective To investigate the effect of the increased pulse pressure on cerebrovascular hemodynamic index.Methods From January 2014 to October 2016,the application of the method of cross-sectional study,6 006 consecutive health subjects examined and detected with ultrasound noninvasive cerebral hemodynamic index (CVHI) at the Physical Examination Center,Pu′er People′s Hospital,Yunnan Province were enrolled.In order to control the influence of age and gender on the results,according to age and gender in the increased pulse pressure group (≥60 mmHg),and the same sex and age difference of not more than 1 years old were selected as the inclusion criteria in the normal pulse pressure group (60 mmHg).Finally,1 115 subjects were enrolled as a control group for comparative analysis.The study population was divided into an increased pulse pressure group (n=590) and a normal pulse pressure group (n=1 115) in a mixed manner.The differences of CVHI index and its integral score of both groups were compared.The correlation of the increased pulse pressure level and changes of cerebrovascular hemodynamic accumulative scores were analyzed.Results The minimum velocity,mean velocity,and critical pressure in the increased pulse pressure group were significantly lower than those in the normal pulse pressure group (P<0.05),while the differences of the peripheral vascular resistance,characteristic impedance,pulse wave velocity,dynamic resistance,diastolic blood pressure,and critical pressure were significant higher than those in the normal pulse pressure group.There were significant differences (P<0.01).The integral values of cerebral hemodynamics in the increased pulse pressure group and the normal pulse pressure group were 76±22 and 88±19 respectively.There was significant difference (P<0.01).The proportion of the integral value <75 was 34.4% (203/590) and 15.6% respectively (174/1 115,P<0.01).With the increase of pulse pressure level,the integral value of cerebral hemodynamics showed a significant downward trend,there was a significant negative correlation between the two (r=-0.312,P<0.01).Conclusion The increased pulse pressure may result in the changes of cerebral hemodynamic indexes and its integral values.There is a significant negative correlation between the pulse pressure level and the integral value of cerebral hemodynamics.

Objectives:To understand the medical students'cognition of violence injury medical and the impact of medical injury events reports on medical students.Methods:A sample survey was conducted among 480 medical students in a medical university using self-developed questionnaire.Results:A total of 63.67％ of the medical students get violence injury events information through television news;more than 90％ of medical students were concerned about the media reports of violence injury medical events.The media reports of violence injury medical events had an important impact on medical students,and especially television reports had the greatest impact.41.2％ of the students would enhance their awareness of protection;37.9％ of medical students thought that work passion and enthusiasm would decline;the impact of reports on men was bigger than women (P ＜ 0.05).Conclusion:The report of violence injury medical events has an important impact on medical students.The media should improve self-discipline,create a harmonious public opinion environment and promote the healthy development of doctor-patient relationship.

Objective To investigate the expression and biological significance of microRNA-126 in colon cancer tissue.Methods The expression of microRNA-126 in colon cancer tissues and adjacent tissues of colon cancer patients was detected by real-time quantitative polymerase chain reaction (RT-PCR) in 104 patients with colon cancer surgery (total of 104 pairs).The lentiviral vector was used to construct microRNA-126 cell line,and the effects of microRNA-126 on proliferation,migration and invasion of colon cancer cells were further studied in vitro.Results The relative expression of microRNA-126 in colon cancer tissues (0.63±0.11) was significantly lower than that in adjacent tissues (1.08±0.15),the difference was statistically significant(t=14.561,P＜0.01).The positive rate of microRNA-126 expression in colon cancer tissues (61.5％) was significantly lower than that in adjacent cancer tissues (86.5 ％) the difference was statistically significant(x2=16.908,P＜0.05).The expression of microRNA-126 was significantly correlated with Dukes stage,depth of invasion,lymph node metastasis and distant metastasis (P＜0.05).In the Transwell experiment with matrix glue,the number of cell migration in transfection group (11.26±4.85) was significantly lower than that in blank control group (264.37±32.15),the difference was statistically significant (t=23.418,P＜0.01).In the Transwell experiment without matrix glue,the number of cell migration in transfection group (83.75 ± 13.74) was significantly lower than that in blank control group (339.64 ± 26.38),the difference was statistically significant(t=12.682,P＜0.01).MicroRNA-126 could inhibit the proliferation and invasion of SW480 cells.Conclusion MicroRNA-126 can significantly inhibit the development of colon cancer cells and affect the biological behavior of colon cancer cells.

Objective The study was to investigate the relationship among angiotensin 1-converting enzyme(ACE), plasminogen activator inhibitor-1 (PAI-1)gene polymorphisms and the common carotid artery (CCA-IMT), and the predicting effects of them on CCA-IMT in newly diagnosed type 2 diabetes (T2DM). Methods The polymorphisms of ACE (I/D) gene and PAI-I (4G/5G) gene were deter-mined by polymemse chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific polymerase chain reaction (AS-PCR) method in 308 cases with T2DM. CCA-IMT was compared among the groups with different genotypes of ACE and PAI-1. The in-dependent or synergistic effects of the ACE I/D and PAI-1 40/5G polymorphisms on CCA-IMT in 308 patients with T2DM were analyzed with multivariate linear regression. Then the 156 newly diagnosed type 2 diabetics (durations< I year) without AS received the maltifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. The differences of metabolic control, ACE (I/D) and PAId (40/5G) gene polymorphisms were analyzed. Logistic regression analysis was used to analyze the eorrelation among the CCA-IMT, ACE (I/D) and PAI-1 (4G/5G) polymorphisms. Results Patients with ACE DD genotypes had higher CCA-IMT than those with ACE-Ⅱ or ACE ID genotypes. Patients with both ACE DD and PAI-1 404G genotypes had a higher CCA-IMT than those with any other pairs of genotypes. Multivariate linear regression analysis showed that ACE DD and PAI-1 4G4G gene polymorphisms had synergistic effect on the CCA-IMT in T2DM patients. After 2 years multifactorial intervention, the frequencies of PAI-1 4G alleles and 404G genotypas were lower than those in the CCA-IMT non-inereasing group. Conclusions These findings indicate that the ACE-DD geno-type and its synergistic effects with the PAI-1 4G/4G genotype are independent risk factors for the CCA-IMT in T2DM patients. Under multi-factorial intervention for 2 years, PAI-1 4G/4G genotype may be a negative predictor for the progression of CCA-IMT in T2DM patients.

Objective To summarize the clinical presentation, pathology features, and treat-ment principle for primary testicular non-Hodgkin's lymphoma. Methods Twelve patients were di-agnosed with primary testicular lymphoma. The mean age was 62 years (36-78). Of the patients, unilateral primary testicular tumors were found in 11 cases and bilateral tumors were found in 1 case. All cases had swollen testes, 3 cases had mild pain and 1 had low-grade fever. Ultrasonic examination detected solid mass in all 12 cases. CT scan revealed retroperitoneal enlarged lymph nodes in 3 cases. Nine patients were diagnosed with disease of stage Ⅰ E, 2 of stage Ⅱ E, and 1 of stage Ⅲ E. All of the patients underwent radical orchiectomies. Postoperative treatment included: CHOP chemotherapy for 10 cases, radiotherapy after chemotherapy for 5 cases, and surgery alone for 2 cases. Results Post-operative pathology results were non-Hodgkin's lymphoma in all cases. One patient lost in follow up, one died within 2 years because of other disease. The 1, 3 and 5 year actual survival rates were 82% (9/11) ,40%(4/10),20% (2/10), respectively. The relapsed organs included contralateral testis(3/ 11), central nervous system(3/11), liver(1/11)and retroperitoneal lymph node(1/11). Conclusions The prognosis of the primary testicular non-Hodgkin's lymphoma is very poor. Chemotherapy must be used after surgery for any stage. Stage Ⅰ E and Ⅱ E patient should be treated by surgery combined with radiotherapy and chemotherapy. Contralateral testis should be irradiated prophylactically. Pa-tients beyond stage Ⅱ E should accept chemotherapy after surgery and radiotherapy according to the patient's status.

Midkine (MK) , a newly discovered heparin - binding growth factor, promotes growth, survival, and migration in various cells. Meanwhile, MK stimulates statistically significant forms in new arterioles and capillaries, causes vascular remodeling, prevents ischemia myocardial cells from injury via inhibiting apoptosis. MK also regulates the level of blood - fat.In general, MK plays key roles in cardiovascular diseases.

Objective To study the combination effects of telmisartan and pioglitazone on the expression of heparanases (HPA) and podocin in the kidney of diabetic nephropathy (DN) rats and its possible mechanism. Methods DN model rats were established by intraperitoneal injection with STZ for 12 weeks. All the DN rats were randomly divided into telmisartan group (T group), pioglitazone group (P group), combination of telmisartan and pioglitazone group (L group), and DN group (D group). Healthy rats were chosen as healthy control group(N group). After garage with drugs for 12 weeks, 24-h urinary protein and serum biochemical indicators were examined. RT-PCR and immunohistochemistry methods were applied to detect the mRNA and protein expression of HPA and podocin. Results Compared with T group and P group, 24-h urinary protein of L group was markedly decreased(P<0.05). Compared with the N group, the level of fasting blood glucose, relative renal weight, BUN and Scr in other 4 groups were markedly increased (P<0.05). Compared with T group and P group, the Scr level and the expression of HPA mRNA and protein in L group was markedly decreased (P<0.05), and the protein and mRNA expression of podoein in L group was markedly increased (P<0.05). Conclusion Combination of telmisartan and pioglitazone can down-regulate the mRNA and protein expression of HPA of glomerular basement membrane and up-regulate the protein expression of podocin of podocyte in DN rats, which may ameliorate the proteinuria.

Objective To explore the role of hypoxia inducible factor 1α(HIF-1α)-mediated signaling pathway in angiotensin Ⅱ(Ang Ⅱ)induced renal interstitial fibrosis. Methods Renal tubular epithelial cells were cultured and treated with different concentrations (10-9-10-6 mol/L)of Ang Ⅱ for 24 h and 48 h.Real-time quantitative PCR and Western blotting were preformed to detect the mRNA and protein expressions of HIF-1α,prolyl hydroxylase 2 (PHD2)and tissue inhibitor of metalloproteinase 1 (TIMP-1)in renal tubular epithelial cells. Results HIF-1αmRNA level was increased with Ang Ⅱ treatment in a concentration dependent manner.When cells were treated with Ang Ⅱ concentration at 10-7mol/L for 24 h,the mRNA level was markedly increased by 166%.Furthermore,by real-time quantitative PCR and Western blotting,compared with the control group,Ang Ⅱincreased the mRNA and protein levels of HIF-1α and TIMP-1 (P<0.05,respectively),while the mRNA and protein levels of PHD2 were decreased markedly (P<0.05,respectively)in renal tubular epithelial cells.Conclusion Ang Ⅱ reduces HIF-1αdegradation in renal tubular epithelial cells probably by reducing the expression of PHD2,which increases the expressions of HIF-1α and TIMP-1 involved in renal interstitial fibrosis.

Objective The analysis healthy crowd skull magnetic resonance image formation(MRI) inspection result,understood healthy crowd skull common disease the type,favors the healthy physical examination project the reasonable establishment.Methods Medical Center sent medical examination of 380 cases of brain MRI data and retrospective analysis.Results 380 cases of brain MRI results show healthy physical examination:there are 9 kinds of disease,MRI exception occurred there were 109 cases,abnormal rate of 28.7％ ; by age is divided into three groups:30-40 sui,41-50 sui; 51-60 sui; 51-60 sui exception rate was highest in the age group,to 56.9％ ; the discovery of the disease,the highest incidence of disease with multiple lacunar cerebral infarction,73.4％ per cent of total incidence.Conclusion MRI no radiation,brain MRI examination should as a general project of middle and old aged healthy,early detection of brain tumor lesions and cerebral vascular lesion,disease prevention and healthy living for guidance.